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The field of clinical psychology has rapidly evolved in its 125-year history in North America. Initially solely an academic discipline, it is now dominated by the clinical practice of psychotherapy. However, a commitment to research as well as the integration of clinical practice and research continue to be core values of the profession. Both types of psychology doctoral degrees require research and clinical training, although the emphasis on research is greater in Ph.D. Programs, and the emphasis on clinical training is greater in Psy.D. programs. Practice itself has shifted with fewer psychologists identifying their primary theoretical orientation as psychoanalytic and more as cognitive behavioral. The role of psychologists has expanded within and outside of the healthcare system to include consulting, administration, and closer collaboration with other healthcare providers in areas such as integrated primary care and disease management. Clinical psychology is regulated at the state level, resulting in varying rules on licensure, patient confidentiality, and psychologist prescription privileges throughout the United States. Clinical Psychology is similarly regulated at the provincial level in Canada, though the Mutual Recognition Agreement now allows psychologists licensed in one jurisdiction to practice in all others. National level influences include the Research Domain Criteria, which has changed the requirements for National Institute of Mental Health research funding. The field of clinical psychology is highly influenced by broader healthcare policy at both state/provincial and national levels. In the United States, the Mental Health Parity and Addiction Equity Act and the 2010 Patient Protection and Affordable Care Act have expanded access to mental health treatment; the impact of possible changes to these laws on access to treatment and the type and quality of treatment options available is unknown. In Canada, mental health treatment remains dominated by the public sector with an emphasis on medication over behavioral treatments. This chapter explores issues in training, practice, and regulation, as well as future directions for clinical psychology.

DOI: 10.1007/978-3-319-56194-3_3

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